CHICAGO (Reuters) – US health officials are preparing to release new guidance for physicians who emphasize the need to ask each patient with an obvious respiratory infection about their weapon history.
Jeffrey Manzanares, 33, is in the intensive care unit of the University of Utah Hospital while being treated for vapor injury and other lung infections in Salt Lake City, Utah, USA in September 2019 and provided October 10, 2019. Authorized by Marisela Trujillo via REUTERS  The updated guidance will also provide doctors with advice on how to diagnose and manage patients who may have both a lung infection and a vaping injury.
Dr. Ram Koppaka, a physician at the Centers for Disease Control and Prevention (CDC), said doctors must be aware that there is an overlap between the early symptoms of vaping damage and common respiratory tract infections.
The CDC has already recommended physicians to begin asking patients about their vaping history during routine visits, but gathering information is particularly important because physicians evaluate patients with respiratory symptoms for infectious causes.
"Both diagnoses must be evaluated," Koppaka said in a telephone interview.
The CDC reported on Thursday that as of October 8, 1,999 people in the United States have had confirmed or probable cases of lung damage linked to gunshots, and 26 have died.
Some US doctors have raised concerns that gun damage will be missed in the crushing of patients seeking treatment for seasonal flu and other airways.
The early symptoms of vapor injury include shortness of breath, cough, chest pain, fever, and in some cases gastrointestinal symptoms such as nausea, vomiting and diarrhea. "All of these can also be seen with the flu," Koppaka said.
In the United States, flu activity begins to increase in October and November and usually peaks between December and February.
"The fact that a particular person presenting for clinical evaluation may have the flu, may have lung damage due to e-cigarettes, or both, makes it complicated for suppliers," Koppaka said.
As many as 72% of the earliest vaping patients in Illinois and Wisconsin sought medical treatment at outpatient clinics and emergency rooms before doctors admitted them to a hospital with severe vaping lung injuries, state officials reported last month in the New England Journal. of medicine.
Most of these patients initially received antibiotics. When they failed, many responded to treatment with extra oxygen and steroids.
"ENDED UP IN AGONY"
In addition to influenza, many respiratory infections, including fungal infections, can cause symptoms that can aggravate physicians and delay a vaping diagnosis.
The University of Utah Hospital in Salt Lake City has treated 22 patients with gunshot injuries, including Jeffrey Manzanares, 33, who was also infected with a cold and human metapneumovirus that led to pneumonia.
Manzanares first sought treatment at a local hospital Sept. 3, where he received an antibiotic and oxygen for his pneumonia and was sent home, his anxiety disorder was discovered, he said in a telephone interview.
"I ended up suffering from the lack of oxygen. It felt like someone stabbed a knife all over his body, he said.
He went to the University of Utah Hospital the next day, where he spent 21 days, 17 of which were in intensive care. During his illness, Manzanares said he lost 22.7 kg, one-third of his normal body weight.
"He was crazy," Dr. Scott Aberegg, a pulmonologist who treated Manzanares. "If there is someone who has been harmed by what will come during the season of viral pneumonia, this can be very problematic."
Aberegg attended a conference call earlier this month with other doctors who advised the CDC on how clinics should diagnose and manage vaping patients.
He said that many doctors who get back a positive flu test may just assume that the patient has the flu and do not realize that they are also a vaper.
State health officials are on duty.
"We want to make sure we investigate every case reported and make sure we don't miss anything that can be considered influenza or may be associated with vaping or vice versa," Dr. Pam Pontones, Indiana's deputy health commissioner and state epidemiologist, said in a telephone interview.
Influenza can be fatal in people with other underlying diseases.
"It's really important that everyone, but especially people who have underlying lung infections of any kind, should be vaccinated against the flu," Pontones said.
The CDC recommends that everyone over the age of six should get the flu.
Reporting by Julie Steenhuysen; Editing by Bill Berkrot